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The Causes of Heartburn Now a Mystery

December 10, 2012
Plain English Version

Common heartburn affects 44 percent of Americans at least once a month. The general belief is that it is caused by acid irritation, called GERD. The usual treatment is a proton-pump inhibitor. A popular brand is Prilosec.

However, one-half of those getting the treatment, which is available over-the-counter or by prescription, do not experience relief.

Researchers are finding new causes. The most widespread is called functional heartburn. It means doctors cannot find the cause. For example, when doctors examine the esophagus, half of the patients who do not get relief usually show no sign of acid erosion. This condition is called NERD.

The largest group of NERD patients is younger, thinner women.

Doctors say NERD heartburn may be caused by a reflux of bile rather than stomach acid. A new test can find nonacid reflux, including bile.

Another cause may be a very sensitive esophagus. A third cause may be psychological stress. Lastly, it may be the damage is not yet present or the heartburn drugs are hiding the damage. A doctor said, “It is probably a bunch of different conditions put together in one basket.”

When they cannot find the reason, the usual treatment for all heartburn, such as changes in diet and weight, are still the most popular.

However, new studies are sure to find new causes and treatments.

The Wall Street Journal

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